Thyroid Cancer and Medical Negligence

Thyroid cancer is a rare type of cancer accounting for less than 1% of all cancer cases in the UK. The numbers are however increasing and each year, and 2,700 people are diagnosed with thyroid cancer in the UK.

It is most common in people aged 35 to 39 years and in those aged 70 years or over. Surprisingly it is 2 or 3 times more likely to occur in women, the reasons being mainly to do with hormonal differences.

The Thyroid Gland

The thyroid gland is made up of two lobes located at the base of your neck. It makes two hormones which are absorbed into the blood stream: thyroxine (T4) and triiodothyronine (T3).

These hormones are necessary to regulate the growth and rate of function of many cells and systems in the body to work properly including controlling the speed of your metabolic rate. The hormones also control the amount of calcium circulating in your blood.

Types of Thyroid Cancer

Papillary – This is the most common of thyroid cancers. It accounts for around 60% of cases and is more common in younger people and women;

Follicular – This accounts for around 30% of thyroid cancers and is more likely to occur in older people;

Medullary – This is rarer, and accounts for around 5-8% of thyroid cancer cases. Unlike the other types it can sometimes be hereditary;

Anaplastic – This is the rarest but most aggressive types of thyroid cancers, which most often occurs in people over the age of 60.

Symptoms

Most cancers of the thyroid gland are slow growing and in many cases it can be some time before the symptoms become noticeable.

The most common symptoms of thyroid cancer are:

A painless lump or swelling in the neck which gradually increases in size;

Difficulty in swallowing;

Difficulty in breathing;

A sore throat;

Unexplained hoarseness of the voice that does not improve.

If you experience these symptoms it is important to see your GP as soon as possible for further investigation. Only around 1 in 20 swellings or lumps in the neck are caused by thyroid cancer[1]. Most cases are caused by non cancerous enlargement of the thyroid gland called a goitre.

Goitres are usually caused by less serious problems with your thyroid gland such as having an overactive thyroid gland (hyperthyroidism) or an underactive thyroid gland (hypothyroidism).

Diagnosis

The first stage of diagnosing thyroid cancer starts with a consultation with your GP.

Examination

On presentation of these symptoms, your GP should examine your neck and ask you about all of the symptoms you are experiencing.

Blood test

Your GP should arrange for you to have a blood test to check the functioning of your thyroid. This will show whether your symptoms are caused by any less serious problems with your thyroid. This test measures the amount of certain types of hormones in your blood.

If your blood test shows that your thyroid gland is working normally then you will need to undergo further tests.

Fine-needle aspiration

Your GP will refer you to a hospital for this test. A small needle is inserted into the lump in your neck which takes a small sample of the cells to be tested. The cells will be closely examined under a microscope and it will usually reveal whether any of the cells are cancerous and if they are, what type of thyroid cancer it is.

Further tests

Sometimes the results from the fine-needle aspiration can come back inconclusive and you should ensure that you are referred for further testing to ensure you have a definitive diagnosis. If you have received a diagnosis, further testing can also help determine what the most effective treatment is for you.

Further tests include having a repeated fine-needle aspiration combined with an ultrasound scan. CT or MRI scans may also be recommended.

In some cases if thyroid cancer cannot be ruled out, the only way to confirm a definitive diagnosis would be to undergo surgery to remove the part of the thyroid gland that contains the lump for testing.

Treatment

Surgery is usually recommended first to treat thyroid cancer, but a treatment plan will be devised for each individual patient depending on their grade of cancer and whether it is likely that a complete cure can be achieved.

The procedure is known as a Thyroidectomy which can be total or partial. The type of operation depends on a variety of factors such as the type of thyroid cancer, your age, the size of the lump and the results of your investigations.

After a Thyroidectomy, patients will need to take prescribed medication, known as T4 for the rest of their life to help regulate hormone levels and mimic the previous function of your thyroid. You will also need to have regular blood tests and check ups to monitor your thyroid hormone levels.

Some patients may require radiotherapy treatment with radioactive iodine to ensure that all the thyroid cancer cells are destroyed to prevent them from returning.

In some cases where the stage of cancer is advanced, it may sadly not be possible to achieve a cure however some treatments such as chemotherapy can be used to help slow down the progression of the cancer.

Where can negligence occur?

Medical negligence can occur for patients either before or after they have received a diagnosis of thyroid cancer.

It is highly important that thyroid cancer is diagnosed and treated at the earliest opportunity. The earlier the diagnosis the higher chance of a better outcome as the disease can develop quickly and in worse case scenarios could be untreatable.

Delayed diagnosis or treatment

Instances where a diagnosis or treatment may be delayed include where your GP does not pick up your symptoms or where you are not examined fully enough. Your GP may not then refer you to a specialist for further investigations when appropriate. A malignant lump can often be mistaken for a goitre or other benign swelling and the seriousness not fully appreciated.

Delays can also occur when abnormal test results are misread or are not acted upon quickly enough. You may also have been diagnosed incorrectly with another condition which will delay you receiving effective treatment.

Consent

It is important that a patient is advised clearly about the different treatment options available and their associated risks and benefits. Thyroid surgery whilst being the most effective way to treat the cancer carries its own significant risks of long term disabilities and complications so it is crucial that the patient can make a fully informed choice as to how to proceed.

Surgical errors

Thyroid surgery is very complex and complications can occur due to substandard medical technique. Other complications such as infection or bleeding can occur, however if the complications could have been avoided with reasonable care then a claim could be made for compensation.

Support

Receiving a diagnosis of cancer is devastating and can often make you feel alone. You may also be anxious for more information about your condition. There are a number of cancer charities and specific thyroid cancer organisations who can provide information, advice, support and a fantastic network of people in your position who you can talk to.

British Thyroid Foundation is a support network for people with thyroid cancer. You can sign up to a newsletter and they have a selection of helpful advice leaflets.

The Butterfly Thyroid Cancer Trust was the first national charity in the UK dedicated solely to supporting those with thyroid cancer. They offer valuable information, support networks and encouraging advice. You are able to talk to others with thyroid cancer through their helpline and they can offer you a ‘buddy’ to help you through your journey.

How we can help

At Bolt Burdon Kemp we pride ourselves on our specialist knowledge of dealing with all kinds of cancer misdiagnosis and treatment issues. We fully appreciate how difficult this process can be for the patient or their loved ones and we will support you through the claim process. A cancer diagnosis is heart breaking on its own and added with the knowledge that more could have been done to help can make it even more overwhelming.

While we know that financial compensation cannot make up for the failing in your treatment, it can give you and your family more security for the future. Compensation is paid both for the effects of the misdiagnosis and other financial losses incurred such as lost earnings or care and assistance. A late diagnosis of thyroid cancer may mean you need extra medical treatment and private care that otherwise would not have been needed. We can help you seek compensation for this so that your main concern is solely your recovery.

I am a Solicitor at Bolt Burdon Kemp specialising in Medical Negligence claims. If you or a loved one are concerned about the thyroid cancer treatment you have received, contact me free of charge and in confidence on 0207 288 4820 or at hannahtravis@boltburdonkemp.co.uk for specialist legal advice. Alternatively, you can complete this form and one of the solicitors in the Medical Negligence team will contact you. You can find out more about the team here.